CDC approved booster of COVID 19 for immunosp

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my little penguin

my little penguin

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Who Needs an Additional COVID-19 Vaccine?
Currently, CDC is recommending that moderately to severely immunocompromised people receive an additional dose. This includes people who have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.
Click to expand...

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html
 
This is for 12 and up, right? My daughters are excited LOL - even though the younger one flared with the first 2 vaccines.
 
It’s for anyone who got moderna (18 & up ) or Pfizer (12 & up ) that can state they are on immunosuppressive medicine .
Already talked it over with the pharmacist.
 
Third shot in and done
Easy
Once the pharmacy worked out the computer program side of things
Which was tricky
But given all of Ds meds today made the most sense timing wise
Otherwise he would have waited till next month for spacing between two biologics and mtx
 
My kiddo is a tough one - we have to find time between steroid shots, a hospitalization and to stop one of her biologics and of course MTX for a week. Both her IBD and arthritis flared with the first shot (IBD flare was worse) and her arthritis flared with the second shot. So she's half excited, half scared to get it.
 
Our GI has T waiting to get the third shot until there are consensus papers written about IBD. Many of the docs I follow on social media are also advising that IBD patients “in general” do not fall into this category and that GI’s should make the recommendation on a case by case basis ie: on anti tnf (studies show little affect on immunity) but work in high risk environment or live with severely immune or high risk person, then get third shot etc.

He recommended O get hers based on the two biologics (even though Entyvio is gut specific), attending school in a high risk state with no mask mandates, and her constant flare state and the fact that she is at high risk of needing steroids at some point this semester.

No spacing shot between meds or holding meds.
 
Interesting - our rheumatologist recommended for both our girls, as did M’s GI. But both are on MTX which is known to reduce antibody formation. And of course M is also on two biologics - an anti-TNF (which is not so bad but does make a difference - there are a couple studies of IBD patients on Remicade) but a JAK inhibitor which really compromises immunity, which she actually has to stop for a week (possibly two). MTX also has to be held for a week.
 
Wanted add even a relative who “only “ has psoriasis and on humira dermatologist recommended the third shot
 
This is interesting. I’m in Toronto Canada and third shot is not being given to anyone with IBD taking any meds. My GI is watching things closely and hopes soon it will be recommended.
 
The hospital system my kiddo goes to sent out the canned messages “based on our records your child is immunocompromised “ and the hospital recommends the third shot COVID.

So I really think is does vary
Granted my kiddo is on two biologics and mtx so no studies on anyone with that and COVID .
 
Yes, we were told the reason they did not recommend that for the two dose mRNA vaccines was because they were 3-4 weeks apart. So if you held MTX 2 weeks after each vaccine, it would be held a long time (4 weeks) and would put patients at risk for a flare. Since J&J was only 1 vaccine, two weeks was recommended. The 2 week recommendation comes from the studies done on Rheumatoid Arthritis patients for the flu vaccine.

Here is the explanation:

For MTX, the panel recommended that MTX be withheld 1 week after each mRNA vaccine dose for those with well-controlled disease, based on data from influenza vaccines (38, 41, 42, 80, 81) and pneumococcal vaccines (82, 83). The recommendation to withhold MTX for only a single week, rather than the 2-week interruption tested in an RA influenza vaccine trial, was based upon practical considerations for the complexity of withholding MTX for 2 weeks around each of the 2 vaccine doses that are spaced 3–4 weeks apart and the potential for flare associated with withholding MTX for this long. For that reason, interrupting MTX for only 1 week around the time of each of the vaccine doses was recommended. In contrast, for single-dose COVID vaccine, the task force recommended that MTX be withheld for 2 weeks, which is consistent with the influenza vaccine MTX guidelines. Guidance was given for JAK inhibitors based on concern related to the effects of this medication class on interferon signaling that may result in a diminished vaccine response (84, 85). Given the immunologic considerations related to this concern (86), withholding JAK inhibitor therapy was recommended regardless of the patient’s underlying disease activity. Emerging evidence regarding the influence of MTX and JAK inhibitors on vaccine response against COVID-19 was recognized by the task force as supporting the above guidance statements (87).
Click to expand...
 
Yep we could only hold one week before and one
Week after due to timing of mtx and two other biologics - never an ideal time but it was the best scenario given the limitations of other meds
 
3rd dose for immune compromised is now being offered in Canada. If any Canadians are wondering. H is still too young. C is eligible (weekly dose Humira) but I want to discuss with GI first.
 
Pilgrim said:
3rd dose for immune compromised is now being offered in Canada. If any Canadians are wondering. H is still too young. C is eligible (weekly dose Humira) but I want to discuss with GI first.
Click to expand...
I spoke to my GI and it is not being offered to people taking humira for any IBD
 
Pilgrim said:
This was Ontario and listed anti-tnf meds as eligible.
Click to expand...
Yes, I’m in Ontario and yes the meds are on the list but the people that have had transplant or other serious medical issues are able to get booster, IBD patients are not eligible yet.
 
That's odd because anti-TNFs are mostly used for autoimmune diseases - RA, Crohn's, UC, Ankylosing Spondylitis, Uveitis etc. They're not used for transplant patients as far as I know (though perhaps I'm wrong).
So if anti-TNFs make you eligible, then any person, including a child over age 12 on anti-TNFs should also be eligible. That's how it worked here and anti-TNFs did make you eligible in the US. My daughter is finally going to get her third dose in the next couple of days. Her rheumatologist and GI both told her to get the third dose.
 
Maya142 said:
That's odd because anti-TNFs are mostly used for autoimmune diseases - RA, Crohn's, UC, Ankylosing Spondylitis, Uveitis etc. They're not used for transplant patients as far as I know (though perhaps I'm wrong).
So if anti-TNFs make you eligible, then any person, including a child over age 12 on anti-TNFs should also be eligible. That's how it worked here and anti-TNFs did make you eligible in the US. My daughter is finally going to get her third dose in the next couple of days. Her rheumatologist and GI both told her to get the third dose.
Click to expand...
Ya, I’m not sure. He just told me that I’m not eligible yet. He said everyone is going to need a booster soon. He also mentioned people taking drugs like Imuran and Methotrexate are more immune compromised and would possibly qualify. But I only take humira.
 
  • Those undergoing active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive.
Individuals in these groups can receive their third dose at a recommended interval of eight weeks following their second dose and will be contacted by their health care provider such as their primary care provider, specialist, or their hospital specialty program when they are eligible to receive the vaccine.

Locations and timing for third doses may vary by public health unit and high-risk population based on local planning and considerations, with third doses mainly to be administered at transplant clinics and cancer clinics.
 
MTX falls under anti-metabolites by the way. Just in case anyone has a kiddo also on MTX.
 
Covid prevent study now is getting antibody levels after the 3rd shot
Ds just got the email
I will update once he gets the antibody test results back
He got his third shot in August after it was fda recommended
 
Ds got his results back
Cov2IGG quantitative test through labcorp and university of North Carolina ibd PREVENT. Study
After 2 shots —92
After 3 shots —148
Anything above 1 is considered positive for antibodies
Anything over 30 is considered very high
He was outside their reference range high both times
 
my little penguin said:
Ds got his results back
Cov2IGG quantitative test through labcorp and university of North Carolina ibd PREVENT. Study
After 2 shots —92
After 3 shots —148
Anything above 1 is considered positive for antibodies
Anything over 30 is considered very high
He was outside their reference range high both times
Click to expand...
So, he would have been well covered by 2 doses? Good to know!
 
We don’t know what levels are needed for adequate Response to prevent Covid infections
Or even which part of the immune system T cells versus antibodies are better or how much …
That is why Ds is in the 18 month study
Right now the numbers are meaningless
But in a year or two they will know what they mean
They only thing they know at this point is
His body did produce a response to 2 shots and a higher response to 3 shots
The study leaders don’t tell us any more than that anything above a 1 is considered a response



what they do know is
Immunocompromised folks (including ibd kids) have a higher rate of break through infections even after two doses -so they recommended a third full dose -

that said Ds seems to be following the trend of higher response to those on Stelara vs other ibd meds
But we held his methotrexate for the shots
And he is on a second biologic (iL-1) as well for other auto inflammatory condition
 
my little penguin said:
Ds got his results back
Cov2IGG quantitative test through labcorp and university of North Carolina ibd PREVENT. Study
After 2 shots —92
After 3 shots —148
Anything above 1 is considered positive for antibodies
Anything over 30 is considered very high
He was outside their reference range high both times
Click to expand...
Got my results of antibody draw this week (taken after third dose) and went from 43 after first dose to 176 after third (timing didn't have me tested in between). Seemed crazy high but glad that others are in the same range (since it's off their charts). Will be interested what they learn longer term about adequate levels.

Happy to have the protection (and to test negative today)...surgery on Monday.
 

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